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Poster display session

2286 - Untreated hormone receptor positive / HER2-negative metastatic breast cancer survival with front-line chemotherapy and maintenance endocrine therapy

Date

11 Sep 2017

Session

Poster display session

Topics

Cytotoxic Therapy;  Breast Cancer

Presenters

Renaud Sabatier

Citation

Annals of Oncology (2017) 28 (suppl_5): v74-v108. 10.1093/annonc/mdx365

Authors

R. Sabatier, A. Meskine, M.A. Cappiello, J. Extra, C. Tarpin, F. Rousseau, M. Provansal, F. Bertucci, P. Viens, A. Gonçalves

Author affiliations

  • Medical Oncology, Institute Paoli Calmettes, 13274 - Marseille/FR
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Resources

Abstract 2286

Background

Except some life threatening cases, combination of endocrine therapy and CDK4/6 inhibitors is becoming the standard first line treatment for women with hormone receptor (HR) positive/HER2 negative advanced and metastatic breast cancer (MBC). However cost-effectiveness analyzes are lacking concerning this therapy. As chemotherapy also targets cell cycle we wondered how sequential combination of chemotherapy and maintenance endocrine therapy could be effective as first line treatment for naive HR+/Her2- MBC.

Methods

We retrospectively collected from our institutional database (“Institut Paoli-Calmette”, Marseille, France) cases with naive HR+/HER2- MBC. We selected patients treated with chemotherapy plus maintenance endocrine therapy as first line treatment between January 2000 and December 2015. Progression-free survival (PFS) and Overall Survival (OS) were analyzed using the Kaplan-Meier's method. We also conducted univariate (UV) and multivariate analyzes including menopausal status, visceral disease, pathological subtype, and progesterone receptor expression assessed by immunohistochemistry.

Results

A total of 183 female patients were included with a median age at diagnostic of 56,9 years. Most of them were postmenopausal (n = 114, 65.9%) and 108 (59.7%) had visceral metastases. Anthracyclynes-Taxanes combinations were used for 162 patients (88.5%). Median number of chemotherapy cycles was 6. Endocrine therapy was aromatase inhibitors and tamoxifen for 120 (67.8%) and 56 (31.6%) cases, respectively. Median PFS was 33 months [95CI = 25-38] and median OS was 79 months [95CI = 63-101]. In UV analysis pre-menopausal status (HR = 0.58), non-ductal non-lobular subtype (HR = 0.47), and absence of visceral disease (HR = 0.51) were correlated to better OS. All these features remained significant in multivariate analysis. We observed no death related to treatment.

Conclusions

Following these results, and with the issues of cost-effectiveness related to newly approved therapies, first-line chemotherapy plus maintenance endocrine therapy may be considered for untreated HR+/HER2- MBC.

Clinical trial identification

Legal entity responsible for the study

Institut Paoli-Calmettes

Funding

None

Disclosure

R. Sabatier: Travel grants: Pfizer. Consultant: Novartis, Pfizer. Investigator in clinical trials promoted by Novartis and Lilly. F. Bertucci: Investigator in clinical trials promoted by Novartis and Lilly. A. Gonçalves: Consultant: Novartis. Investigator in clinical trials promoted by Novartis and Lilly. All other authors have declared no conflicts of interest.

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